TY - JOUR
T1 - Association of Pretreatment Hippocampal Volume With Neurocognitive Function in Patients Treated With Hippocampal Avoidance Whole Brain Radiation Therapy for Brain Metastases
T2 - Secondary Analysis of NRG Oncology/RTOG 0933
AU - Abraham, Christopher D.
AU - Pugh, Stephanie L.
AU - Bovi, Joseph A.
AU - Gondi, Vinai
AU - Mehta, Minesh P.
AU - Benzinger, Tammie
AU - Owen, Christopher J.
AU - Lo, Simon S.
AU - Kundapur, Vijayananda
AU - Brown, Paul D.
AU - Sun, Alexander Y.
AU - Howard, Steven P.
AU - DeNittis, Albert S.
AU - Robinson, Clifford G.
AU - Kachnic, Lisa A.
N1 - Funding Information:
Sources of support: This project was supported by grants UG1CA189867 (National Cancer Center Institute Community Oncology Research Program), U10CA180868 (NRG Oncology Operations), U10CA180822 (NRG Oncology statistical and data management center), and U24CA180803 (Imaging and Radiation Oncology Core), from the National Cancer Institute.
Funding Information:
Sources of support: This project was supported by grants UG1CA189867 (National Cancer Center Institute Community Oncology Research Program), U10CA180868 (NRG Oncology Operations), U10CA180822 (NRG Oncology statistical and data management center), and U24CA180803 (Imaging and Radiation Oncology Core), from the National Cancer Institute. Disclosures: Dr Benzinger reports grants and investigator-initiated research such as clinical trials from Avid Radiopharmaceuticals/Eli Lilly, clinical trials from Roche, and other from Biogen and Merck. Dr Bovi reports being a paid consultant for Elekta. Dr Brown reports receiving personal fees from UpToDate. Dr Gondi reports receiving personal fees and honararia from UpToDate. Dr Kachnic reports receiving royalties from UpToDate and an honorarium from TRMOncology. Dr Lo reports being a member of the Gamma Knife ICON Expert Group from Elekta AB. Dr Mehta reports receiving personal fees from Insys, Remedy, Iba, Varian, Celgene, Abbvie, Astra Zeneca, Tocagen, and Blue Earth Diagnostics and serving on the Board of Directors (Options) for Oncoceutics. Dr Pugh reports receiving salary support paid to NRG Oncology from Millennium and Pfizer-Astellas. Dr Robinson reports receiving grants and personal fees from Varian, grants from Elekta, and equity from Radialogica. All other authors have no disclosures to declare.
Publisher Copyright:
© 2021 The Authors
PY - 2022/11/1
Y1 - 2022/11/1
N2 - Purpose: Hippocampal volume (HV) is an established predicting factor for neurocognitive function (NCF) in neurodegenerative disease. Whether the same phenomenon exists with hippocampal-avoidant whole brain radiation therapy is not known; therefore, we assessed the association of baseline HV with NCF among patients enrolled on RTOG 0933. Methods and Materials: Hippocampal volume and total brain volume were calculated from the radiation therapy plan. Hippocampal volume was correlated with baseline and 4-month NCF scores (Hopkins Verbal Learning Test–Revised [HVLT-R] Total Recall [TR], Immediate Recognition, and Delayed Recall [DR]) using Pearson correlation. Deterioration in NCF was defined per the primary endpoint of RTOG 0933(mean 4-month relative decline in HVLT-R DR). Comparisons between patients with deteriorated and nondeteriorated NCF were made using the Wilcoxon test. Results: Forty-two patients were evaluable. The median age was 56.5 years (range, 28-83 years), and 81% had a class II recursive partitioning analysis. The median total, right, and left HVs were 5.4 cm3 (range, 1.9-7.4 cm3), 2.8 cm3 (range, 0.9-4.0 cm3), and 2.7 cm3 (range, 1.0-3.7 cm3), respectively. The median total brain volume was 1343 cm3 (range, 1120.5-1738.8 cm3). For all measures of corrected HV, increasing HV was associated with higher baseline HVLT-R TR and DR scores (ρ: range, 0.35-0.40; P-value range,. 009-.024) and 4-month TR and DR scores (ρ: range, 0.29-0.40; P-value range,. 009-.04), with the exception of right HV and 4-month DR scores (ρ: 0.29; P = .059). There was no significant association between HV and NCF change between baseline and 4 months. Fourteen patients (33.3%) developed NCF deterioration per the primary endpoint of RTOG 0933. There was no significant difference in HV between patients with deteriorated and nondeteriorated NCF, although in all instances, patients with deteriorated NCF had numerically lower HV. Conclusions: Larger HV was positively associated with improved performance on baseline and 4-month HVLT-R TR and DR scores in patients with brain metastases undergoing hippocampal-avoidant whole brain radiation therapy but was not associated with a change in NCF.
AB - Purpose: Hippocampal volume (HV) is an established predicting factor for neurocognitive function (NCF) in neurodegenerative disease. Whether the same phenomenon exists with hippocampal-avoidant whole brain radiation therapy is not known; therefore, we assessed the association of baseline HV with NCF among patients enrolled on RTOG 0933. Methods and Materials: Hippocampal volume and total brain volume were calculated from the radiation therapy plan. Hippocampal volume was correlated with baseline and 4-month NCF scores (Hopkins Verbal Learning Test–Revised [HVLT-R] Total Recall [TR], Immediate Recognition, and Delayed Recall [DR]) using Pearson correlation. Deterioration in NCF was defined per the primary endpoint of RTOG 0933(mean 4-month relative decline in HVLT-R DR). Comparisons between patients with deteriorated and nondeteriorated NCF were made using the Wilcoxon test. Results: Forty-two patients were evaluable. The median age was 56.5 years (range, 28-83 years), and 81% had a class II recursive partitioning analysis. The median total, right, and left HVs were 5.4 cm3 (range, 1.9-7.4 cm3), 2.8 cm3 (range, 0.9-4.0 cm3), and 2.7 cm3 (range, 1.0-3.7 cm3), respectively. The median total brain volume was 1343 cm3 (range, 1120.5-1738.8 cm3). For all measures of corrected HV, increasing HV was associated with higher baseline HVLT-R TR and DR scores (ρ: range, 0.35-0.40; P-value range,. 009-.024) and 4-month TR and DR scores (ρ: range, 0.29-0.40; P-value range,. 009-.04), with the exception of right HV and 4-month DR scores (ρ: 0.29; P = .059). There was no significant association between HV and NCF change between baseline and 4 months. Fourteen patients (33.3%) developed NCF deterioration per the primary endpoint of RTOG 0933. There was no significant difference in HV between patients with deteriorated and nondeteriorated NCF, although in all instances, patients with deteriorated NCF had numerically lower HV. Conclusions: Larger HV was positively associated with improved performance on baseline and 4-month HVLT-R TR and DR scores in patients with brain metastases undergoing hippocampal-avoidant whole brain radiation therapy but was not associated with a change in NCF.
UR - http://www.scopus.com/inward/record.url?scp=85139298519&partnerID=8YFLogxK
U2 - 10.1016/j.adro.2021.100859
DO - 10.1016/j.adro.2021.100859
M3 - Article
C2 - 36420209
AN - SCOPUS:85139298519
SN - 2452-1094
VL - 7
JO - Advances in Radiation Oncology
JF - Advances in Radiation Oncology
IS - 6
M1 - 100859
ER -